Sandbox Rim: Difference between revisions
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For [[penicillin]]-allergic patients, substitute [[aztreonam]] for above [[b-lactam]]</td></tr> | For [[penicillin]]-allergic patients, substitute [[aztreonam]] for above [[b-lactam]]</td></tr> | ||
<tr><td>Concern about community acquired [[MRSA]] </td><td> Add [[vancomycin]] or [[linezolid]]</td></tr> | <tr><td>Concern about community acquired [[MRSA]] </td><td> Add [[vancomycin]] or [[linezolid]]</td></tr> | ||
</table> | |||
Revision as of 20:09, 19 February 2015
| Scenario | Recommendation |
|---|---|
| Outpatient: Previously healthy and no use of antibiotics within the last 3 months | A macrolide, OR Doxycyline |
| Outpatient: Presence of comorbidities (diabetes mellitus; chronic heart, lung, liver or renal disease; alcoholism; malignancies; asplenia; immunosuppression) | A fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacin [750 mg]), OR A b-lactam plus a macrolide |
| Outpatient: Use of antibiotics within the last 3 months | An alternative from a different class should be selected: A fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacin [750 mg]), OR |
| Outpatient: In regions with a high rate (125%) of infection with high-level (MIC 16 mg/mL) macrolide-resistant Streptococcus pneumoniae | A fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacin [750 mg]), OR A b-lactam plus a macrolide |
| Inpatient general medical ward | A fluoroquinolone, OR A b-lactam plus a macrolide |
| Inpatient ICU | A b-lactam (cefotaxime, ceftriaxone, or ampicillin-sulbactam) plus azithromycin, OR A b-lactam (cefotaxime, ceftriaxone, or ampicillin-sulbactam) plus a fluoroquinolone, OR For penicillin-allergic patients: a fluoroquinolone plus aztreonam |
| Outpatient: Concern about pseudomonas | An antipneumococcal, antipseudomonal b-lactam (piperacillintazobactam, cefepime, imipenem, or meropenem) plus either ciprofloxacin or levofloxacin (750 mg), OR B-lactam plus an aminoglycoside and azithromycin, OR B-lactam plus an aminoglycoside and an antipneumococcal fluoroquinolone, OR For penicillin-allergic patients, substitute aztreonam for above b-lactam |
| Concern about community acquired MRSA | Add vancomycin or linezolid |